Chronic hypersensitivity pneumonitis
Increasing shortness of breath for 8 months.
CT Chest - HRCT
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Inspiratory and expiratory scans of the chest have been performed along the dynamic series of the chest.
Extensive changes of pulmonary fibrosis remain stable and there is mosaic attenuation in both lungs exacerbated in the expiratory film.
These appearances are stable when compared to the previous study.
No focal mass within the lungs. Mediastinal lymph nodes are numerous but within normal size limits and are likely reactive.
The changes are characteristic of pulmonary fibrosis.
This patient had a long history of exposure to pigeons as a hobby, and the CT findings are in keeping with end-stage chronic hypersensitivity pneumonitis.
On HRCT, chronic hypersensitivity pneumonitis usually has the following features:
- established pulmonary fibrosis with honeycomb formation
- may see ground glass opacification
- areas of lobular air-trapping